💼 About This Role

You'll process claims for a health plan serving seniors, ensuring timely and accurate payment. You'll work with regulatory guidelines and internal teams to maintain quality standards. This role offers remote work within California.

🎯 What You'll Do

• Examine and process claims per contractual and regulatory standards
• Assess returned, denied, or paid claims for accuracy
• Ensure claim timeliness processing standards are met
• Assist internal and external partners with claims questions

📋 Requirements

• High School Diploma or equivalent
• 3+ years experience processing claims in managed care
• Working knowledge of CPT/HCPCS codes and regulations
• Experience with Medicare/Medicaid claims processing

✨ Nice to Have

• Experience with industry pricing methodologies
• Knowledge of electronic claims processing systems

🎁 Benefits & Perks

• 🏥 Medical, Dental, Vision insurance
• 🏖️ 17 days PTO plus 12 holidays and sick time
• 📈 Advancement opportunities and internal promotion
• 💰 401(k) match and bonus
• 💻 Remote work flexibility